Functional Medicine virtually by secure video for all Californians

The novel Corona Virus causing Covid-19 is washing over all of us, disrupting every aspect of our lives, including how we get healthcare guidance. Small practices like Deena Neff, MD are converting to video or virtual visits with great success. With secure technology, your already scheduled appointment will be converted to a video visit and new appointments will be by video.

  • Video visits from the safety of your home for existing and new patients. 
  • Optimize health with personalized expert recommendations. 
  • Special discounts for video visits. 
  • New membership rates making it easier to connect and share information.

With new rule changes, I am now able to see any California resident via video as a new patient and for on-going care.  Medicare has recognized the importance of staying away from places where one could potentially catch the corona virus so has relaxed their rules around telehealth during this crisis. Medicare now supports doctor visits without restrictions via video (previously you had to live in a rural area to make use of this technology).  Many insurance companies have followed suit, if they hadn’t already embraced this convenient and efficient way of seeing the doctor.

Stay tuned for more information about the novel Corona virus and how to stay safe and optimize your health.

 

Sleep. Your life depends on it.

I’ve noticed a trend in many of my patients:  There is a desire to eke out every bit of the day, and that means staying up late.  Just one more episode of the latest binge.  A little more quiet time without the kids.  A bit more time with their spouse or friends.

But what this means is that the alarm still goes off at the same time the next morning and work starts at the same time regardless.  What gives is sleep.  

Americans are sleeping on average 40% less than they did in the 1940’s.  And 40% are getting 6 hours or less a night.  What suffers with lack of sleep? Your health and how you function both at work and at home. 

What gives when you’re sleep deprived?

  • Weight.  There is a clear connection to weight gain and lack of sleep.
  • High blood pressure.  This is actually the number one cause of death in the world, and too little sleep is a contributor to developing elevated blood pressure.
  • Heart disease.  Nearly 2/3’s of us in the US will die of a heart attack or stroke.  One step towards healthier arteries?  Sleep.
  • Diabetes and insulin resistance.   Lack of sleep worsens our metabolism and contributes to the development of pre-diabetes and diabetes.
  • Cognitive function.  This is apparent in work and school performance.  But, in one recent study, that lack of sleep was shown to increase your risk of Alzheimer’s dementia. 
  • Mood. Most of us have experienced the irritability that comes with a poor night’s sleep.  But is also increases the risk of depression and anxiety.  So unfortunately, anxiety can keep you up and lack of sleep can cause anxiety.
  • Immune system.  This is weakened with lack of sleep, making you more vulnerable to infections, including colds and flu, as well as other more serious infections.
  • Ability to drive.  Hand-eye coordination suffers with lack of sleep and can be as dangerous as driving drunk.
  • Energy.  Fatigue increases with lack of sleep.
  • Libido and fertility.

All of this adds up to not just misery, but to a shortened life expectancy.

So how much sleep do you need?  That depends on your age and how sleep deprived you are.  For most adults, we need between 7 and 9 hours a night.

The most common complaint that patients come to me with is fatigue and the first place to start is looking at their sleep, both for quantity and quality.  Worry and interrupted sleep are 2 big reasons that I see that effect sleep, besides not making enough time for sleep a priority.

Here’s a start to improving the quantity and quality of sleep:

  • Make sure that you give yourself enough time in bed to get enough sleep.  Include in that time space to wind down and do your night time rituals.  This is key and may take some change in your habits.
  • Decrease interruptions.  These often come from a full bladder, a snoring or moving spouse, or pets or children in bed.  Limit the amount of fluid that you drink after dinner so that you are less likely to have to get up to pee.  Put children in their own bed and kick pets out of your bed.  Sometimes mattresses that don’t translate motion across them can be helpful.
  • Make sure that your bed is comfortable and that your bedroom is dark, quiet, and cool.
  • Limit caffeine during the day.  Yes, it can help you make it through with less sleep, but caffeine, with a half life of 6-7 hours, for most of us hangs out in our systems.  This means that you have 1/4 of the caffeine that you had for the morning at bedtime, and might be just enough to add to being awake in the middle of the night.
  • Sleep at regular times, going to bed and getting up at the same time each day.  Our bodies crave regularity and habit.  Focusing on being as consistent as possible, even on the weekends, can go a long way to improving sleep.  Staying up late over the weekend is a big contributor to feeling like Mondays are, well, Mondays.  This is known as social jet lag and takes a couple of days to recover from.
  • Manage your anxiety.  Relaxation recordings, yoga nidra, hypnosis, mediation, and personal biofeedback (like HeartMath) are just some of the ways to help you wind down and go to sleep.
  • Limit alcohol.  Alcohol may help you fall asleep, but it often is a big contributor to awakening in the middle of the night.  Try a period of not drinking, I suggest 3-4 weeks, and see how this effects your sleep.

If you would like to know more about how the new medicine of integrative and functional medicine can help you to optimize your health, schedule a free 15 minute discovery phone call with me.

Schedule Free Discovery Phone Call

Do you know your vascular age?

This Tuesday we have an ultrasonographer coming to the office to take a peak at your carotid arteries to see just how old your arteries are.  If you’re beginning to build up plaque, that’s a sign of “hardening of the arteries,” better known as atherosclerosis and the precursor to most heart attacks and strokes.  Using an ultrasound is a non-invasive, non-toxic way to get a pretty good sense of what your arterial system health status is.

We still have slots left for 10/2/18, so call the office or click the schedule an appointment button and schedule for the CIMT (carotid intimal medial thickness scan).  Even if you’re not a patient yet, call the office and we can start to work together here.  

Thanksgiving Thoughts and Office Schedule

As you prepare for Thanksgiving, whether it’s to travel or to host a feast, I want to suggest that you take a moment each day to acknowledge what you appreciate in your life. In Integrative Medicine and Functional Medicine, we like to use tools that have been shown to have a benefit. It’s been well studied that focusing our thoughts on what we love and appreciate can actually change how our brains function, improving our mood.

Martin Seligman, a psychologist at the University of Pennsylvania, who studies happiness, has 2 exercises based on gratitude that have been proven to increase happiness and wellbeing – the Three Good Things Journal and the Gratitude Visit.

With the Three Good Things Journal, every day write down three good things that happened to you and why you think they happened. In Seligman’s studies, after doing this for a month, people’s moods were elevated and they had less depression which lasted for six months.

In the powerful exercise, the Gratitude Visit, you take a week to write a letter of gratitude to someone who has been especially kind to you, who you have never properly thanked. Then you deliver it in person. This practice has been shown to result in significant improvements in mood for the following month.

I am grateful for the opportunity to be part of your lives, sharing knowledge and practices that enrich us both.

So not only is this a time of harvest festivals around the globe, and preparations for the long dark winter to come, it is a time to gather those that we love and appreciate around us, and to truly give thanks, both for what we have and for the more lasting good cheer it brings.

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We will be closed for the week of Thanksgiving from Tuesday through Friday. And as always, I will be available by phone and email for your emergent needs.

Happy New Year

The office will be closed this week over new years, from Monday 12/29/14 to 1/2/15. I’ll be back on Monday the 5th. Wishing everyone a happy, healthy, fun New Years celebration.

Kale Smoothies

Kale is the basis of my smoothies these days, and the farmer’s markets are overflowing with bunches. I taste a little piece of each kind and pick the sweetest most flavorful variety. These days, the lacinato kale (also known as dinosaur, Tuscan, or black kale) usually wins.

As a member of the Brassica family, also known as cruciferous vegetables, kale is a potent anti-cancer green and can help balance and detoxify hormones. As a dark green leafy veggie, it can also play a large role in keeping your brain healthy as you age. For flavor, I sweeten the smoothie with an apple and/or berries, and add a slice of lemon and a stalk or 2 of celery to balance acidity and salt. Don’t peel the lemon, as the peel has limonene, among a multitude of other antioxidants, phytonutrients and minerals, that can help the strengthen the detoxification pathways of your liver.

Kale Smoothie

Try this recipe for a Vitamix or Magic Bullet smoothie

3-4 leaves of kale
2-3 leaves of romaine lettuce
2 medium stalks of celery (I don’t add the leaves as I find them bitter)
Several stems of cilantro
¼ lemon
1 apple
¼ cup raw cashews
¼ in. slice of fresh ginger
Water and ice to help blend

What Can You Do About Your Stress?

This little video by Dr. Mike Evans packs a big punch. Stress is one of our modern scourges, and as it turns out, there are a few simple things that we can do to leave it mostly behind us. Small changes can indeed make a giant difference in our lives. Did you know that up to 70% of visits to the doctor are stress related? It increases our risks of heart attacks, depression and anxiety, and a poorer quality of life. The pharmaceutical companies do not have a cure. The commonly used SSRI class of antidepressants, for example, is no better than placebo in multiple studies for mild to moderate depression.

But what can help? As it turns out, changing our thinking is the key to managing our stress. The good news is that this can be learned. We can have a big impact on our lives by changing our thinking style by:

  • Cultivating positive thought patterns, or reframing the habitually negative ones
  • Choosing where to put our attention
  • Maintaining a focus on the big picture of our lives
  • Being in the present moment!

Virtually all diseases have better outcomes if we manage our stress well. Check out this video by Dr. Mike Evans for some inspirational and scientific details:

Asparagus is Here!

I love asparagus season. Every year, starting in March there’s a trickling of expensive asparagus, usually from Mexico, and then around April the farmer’s market fills up with the local, sweetest stalks of the year.

A native of Europe, North Africa, and Western Asia, asparagus is in the Lilly family, a cousin of the onion. Many of us know that promptly after eating asparagus, our urine has a distinctive odor. But it seems that only about 50% of Americans can detect this smell, whereas 100% of the French can, and almost no Chinese. There is debate as to whether this difference is because of one’s ability to metabolize what’s in asparagus into the stinky sulfur containing compounds, or is it the actual ability to smell them. It may be a combination of both, but the group 23andme did a population based study and may have found the autosomal dominant gene that allows us to smell that asparagus pee smell.

Its health benefits have been known for millennia throughout Europe and Asia and include cancer prevention and the treatment of heart disease, gout, joint pains, and constipation. It is a diuretic and may help prevent kidney stones and urinary tract infections. Given its high folic acid content, regular consumption can prevent neural tube birth defects. Asparagine, a “non-essential” amino acid (originally isolated from asparagus), is essential to nerve and brain function and has been used as a nerve tonic among herbalists. Asparagus is loaded with antioxidants and many vitamins including vitamins C, A, E and K, folic acid, thiamin, riboflavin, rutin, niacin, and the minerals potassium, iron, phosphorus, copper, magnesium, manganese, selenium, and chromium.

I always enjoy simply steaming or boiling asparagus briefly (2-4 minutes depending on the size) and adding a little olive oil, lemon, salt, and pepper. This year, I’ve also been eating it raw, sliced very thinly in salads with radishes, herbs, and little gem lettuce.

Asparagus scramble:
1 bunch medium sized asparagus, sliced at a diagonal
2 medium red spring onions, coarsely diced
2 tsp Dijon mustard
6 eggs
Salt and pepper to taste

Sauté the onion until translucent, about 5 minutes. Add the asparagus and continue to cook for 2-3 minutes until it turns bright green. Add a pinch of salt. Meanwhile, scramble the eggs, adding the mustard to the eggs until mixed well. Add the eggs to the pan with the onion and asparagus. Cook as you would scrambled eggs. Serve with fresh fruit or a small salad and garnish with chopped parsley or tarragon.

5 Hot Flash Remedies

Menopause can be a challenging time for many women and hot flashes are one of the most troubling symptoms. They can be embarrassing in public or at work, and they often disrupt sleep which makes all of live harder.

There are many small changes that can have big effects on hot flashes. Here are just a few:

Manage Your Stress
Our high adrenaline lifestyle may be why we have a much greater incidence of hot flashes than in other parts of the world. Find a daily method to bring calmness and relaxation that works for you. Breathing exercises can be particularly effect, like “paced breathing” where you count to 5 on the in breath, pause, and count to 5 on the out breath, making in and out the same length of time. Do this for a minimum of 3 breaths at a time, anytime and throughout your day, and notice how your body relaxes more and more with each time you practice.

Ground Flax Seed
This little seed is full of great nutrition and fiber. One small study showed a reduction of hot flashes by 50% with 2 tablespoons of flax seed taken daily. Start at about ½ Tb daily and increase the amount over a week or 2 to the full 2 Tbs. Add it to cereal, salads, or a smoothie. You can sprinkle it on almost any food.

Moderate Exercise
The benefits of daily exercise are remarkable, reducing risks of heart disease, stroke, breast cancer, and osteoporosis. Moderate daily exercise may also reduce hot flashes. Be careful, for some women, overly vigorous exercise may increase them, so pay close attention to your body.

Maca
This “super food” of the Andes was shown in a small study to reduce hot flashes. It may also have many other fantastic benefits for menopause including helping with sleep, concentration, energy, vaginal dryness, and regulating adrenal function. It is generally considered safe since it’s been eaten as a food for millennia, and the dose studied was 2 grams of the dried root daily. Add the powdered form to your daily smoothie or it can be taken in a capsule as a standardized extract of 500 mg daily. As with all herbs, check with your health care provide when taking it, and always have herb holidays.

Bioflavonoids
Rutin, hesperidin and quercetin are common bioflavonoids, well known for their antioxidant and anti-inflammatory properties. Hesperidin is found abundantly in citrus, particularly the peel. An old study from the 1960’s showed relief from hot flashes with the combination of 900 mg hesperidin, 300 mg hesperidin methylchalocone, and 1200 mg of vitamin C daily for four weeks. It can be found in citrus bioflavonoid supplements. You can also get these powerful nutrients by adding lemon or orange slices (including the peel) to your smoothie.